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Background  Cryptosporidiosis is an important cause for chronic diarrhea and death in HIV/AIDS patients. Among common  Cryptosporidium  species in humans,  C. parvum  is responsible for most zoonotic infections in industrialized nations. Nevertheless, the clinical significance of  C. parvum  and role of zoonotic transmission in cryptosporidiosis epidemiology in developing countries remain unclear.    Methodology/Principal Findings  In this cross-sectional study, 520 HIV/AIDS patients were examined for  Cryptosporidium  presence in stool samples using genotyping and subtyping techniques. Altogether, 140 (26.9%) patients were positive for  Cryptosporidium  spp. by PCR-RFLP analysis of the small subunit rRNA gene, belonging to  C. parvum  (92 patients),  C. hominis  (25 patients),  C. viatorum  (10 patients),  C. felis  (5 patients),  C. meleagridis  (3 patients),  C. canis  (2 patients),  C. xiaoi  (2 patients), and mixture of  C. parvum  and  C. hominis  (1 patient). Sequence analyses of the 60 kDa glycoprotein gene revealed a high genetic diversity within the 82  C. parvum  and 19  C. hominis  specimens subtyped, including  C. parvum  zoonotic subtype families IIa (71) and IId (5) and anthroponotic subtype families IIc (2), IIb (1), IIe (1) and If-like (2), and  C. hominis  subtype families Id (13), Ie (5), and Ib (1). Overall,  Cryptosporidium  infection was associated with the occurrence of diarrhea and vomiting. Diarrhea was attributable mostly to  C. parvum  subtype family IIa and  C. hominis , whereas vomiting was largely attributable to  C. hominis  and rare  Cryptosporidium  species. Calf contact was identified as a significant risk factor for infection with  Cryptosporidium  spp., especially  C. parvum  subtype family IIa.    Conclusions/Significance  Results of the study indicate that  C. parvum  is a major cause of cryptosporidiosis in HIV-positive patients and zoonotic transmission is important in cryptosporidiosis epidemiology in Ethiopia. In addition, they confirm that different  Cryptosporidium  species and subtypes are linked to different clinical manifestations.

Distribution and Clinical Manifestations of Cryptosporidium Species and Subtypes in HIV/AIDS Patients in Ethiopia